Objective To assess the clinical efficacy and safety of transurethral plasmakinetic enucleation of prostate (PKEP) and suprapubic transvesical prostatectomy (SPP) in the treatment of large volume benign prostatic hyperplasia (BPH).Methods A total of eighty patients with large volume BPH were selected in the First People''s Hospital of Xuzhou from March 2014 to December 2016,and they were randomly divided into two groups,the PKEP group and SPP group,with 40 cases in each group.The comparison was made between the two groups in terms of operation indicators,postoperative complications followed up for 6 months after surgery and other related curative effect indexes.Results In the SPP group,the intraoperative blood loss was significantly higher than that of the PKEP group ((215.7±10.4) ml vs.(75.6±9.2) ml,t=6.541,P<0.05).There was no significant difference between the two groups in operation time and excised gland volume (P>0.05).But the catheterization time after operation,bladder irrigation time and length of hospital stay were significantly longer in the PKEP group than in the SPP group ((6.3±1.8) d vs.(2.4±0.6) d,(5.5±1.4) d vs.(1.3±0.6) d,(7.7±2.3) d vs.(3.1±0.7) d,t=4.357,2.542,2.975,P<0.05);in the 6-month follow-ups after operation,IPSS,Qmax,PVR and QOL were all significantly improved in both groups compared with the indexes collected before the operation (P<0.05),while there was no significant difference between the two groups (P>0.05).The rate of complication occurrence in the PKEP group were lower than that of the SPP group (P<0.05).Conclusion PKEP was effective in the treatment of BPH,with less bleeding loss,fewer complications and quick recovery.It can significantly improve the life quality of the patients and will be an ideal treatment for large volume BPH.

Objective:To investigate the relationship between preoperative subjective cognitive decline (SCD) and postoperative delirium (POD) in elderly patients.Methods:A total of 292 elderly patients of both sexes, aged 65-90 yr, weighing 50-90 kg, of American Society of Anesthesiologists physical status Ⅰ-Ⅱ, with Mini-Mental State Examination (MMSE) score>23 and Montreal Cognitive Assessment (MoCA) score > 26 at 1 day before operation, underwent total knee/hip arthroplasty under combined spinal-epidural block in our hospital from January to December 2020, were collected.The development of SCD was evaluated using subjective cognitive decline scale at 1 day before operation.Cerebrospinal fluid (CSF) was extracted after successful spinal-epidural anesthesia puncture, the concentrations of β-amyloid protein 40 (Aβ 40), Aβ 42, total tau (t-tau) and phosphorylated tau (p-tau) were determined by enzyme-linked immunosorbent assay.The incidence of POD was evaluated using confusion assessment method during post-anesthesia care unit and at 1-7 days after operation (or before discharge). Patients were divided into POD group and non-POD group according to whether POD occurred within 7 days after operation.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify the risk factor for incidence of POD. Results:A total of 205 patients were enrolled and 53 patients developed POD (25.8%). The results of logistic regression analysis showed that preoperative SCD, and increased CSF p-tau and t-tau concentrations were risk factors for POD of elderly patients, and increased CSF Aβ 42 concentration and Aβ 40/p-tau, Aβ 40/t-tau, Aβ 42/p-tau and Aβ 42/t-tau were the protective factors for POD in elderly patients ( P<0.05). After correction of the confounding factors such as age, sex, body weight, education, the history of smoking and drinking, hypertension, diabetes and coronary heart disease, family history of dementia, Pittsburgh sleep quality index (PSQI), MMSE and MoCA score at 1 day before operation, duration of surgery, duration of anesthesia, intraoperative volume of infusion and blood loss and postoperative pain score, SCD, and increased CSF p-tau and t-tau concentrations were still the risk factors for POD in elderly patients, and increased CSF Aβ 42 concentration and Aβ 40/p-tau, Aβ 40/t-tau, Aβ 42/p-tau and Aβ 42/t-tau were still the protective factors for POD in elderly patients ( P<0.05). Conclusion:Preoperative SCD is the risk factor for POD in elderly patients.

Objective: To investigate the effect of C-phycocyanin (C-PC) on the epithelial-mesenchymal transition (EMT) of cervical cancer Caski cells induced by transforming growth factor beta1 (TGF-β1). Methods: According to different treatment methods, Caski cells were divided into three groups: 10 ng/ml TGF-β1 treatment group, 10 ng/ml TGF-β1+300 μg/ml C-PC co-treatment group and control group (untreated). After 24 h of treatment, the morphological changes of Caski cells were observed, and the effects of TGF-β1 and C-PC on the migration and invasion of Caski cells were detected by Scratch test and Transwell test, respectively. Western blotting was used to detect the effect of C-PC on the expression of epithelial phenotypic marker protein E-cadherin and stromal phenotypic marker protein N-cadherin in TGF-β1-induced Caski cells, and qPCR was used to detect the mRNA expressions of EMT related factors Snail, Zeb1 and Twist. Results: Caski cells in the TGF-β1 treatment group lost the characteristics of the original epithelial phenotype, while the cells in the TGF-β1+C-PC co-treatment group maintained the characteristics of normal epithelial phenotype; the migration rate ([60.0±1.4]% vs [33.5±2.2]%, [40.0±2.8]%, both P<0.05) and the number of invasive transmembrane cells ([108.2±6.2] vs [25.2±3.1], [39.8±5.4], both P<0.01]) of Caski cells in the TGF- β1 treatment group were significantly higher than those in the co-treatment group and the control group. Compared with the control group, the expression of E-cadherin in Caski cells treated with TGF-β1 decreased significantly (P<0.05), while the mRNA expressions of Twist, Snail and Zeb1 increased significantly (all P<0.05); However, co-treatment with C-PC reversed above changes (P<0.05 or P<0.01), and significantly decreased the protein expression level of N-cadherin (P< 0.05). Conclusion: C-PC treatment can inhibit the invasion and metastasis ability of Caski cells induced by TGF-β1 and further affects the EMT process. The mechanism may be related to the decrease of mRNAexpressions of Twist, Snail and Zeb1 by C-PC treatment. ·

OBJECTIVE To investigate the transfer and diffusion of berberine hydrochloride(BBH), the main active component of Coptis and Phellodenticum in the system of carboxymethyl chitosan(CMCS)-sodium alginate(SA). METHODS CMCS and SA were stirred in a certain proportion, and D-gluconolactone(GDL) was added to form polyelectrolyte hydrogel. Rheometer was used to study the rheological properties of CMCS-SA hydrogel, including the elastic modulus G′ and the viscous modulus G′′. A BBH diffusion model for CMCS-SA hydrogel was designed, and the relevant rules of BBH permeation through CMCS-SA polyelectrolyte hydrogel were observed by UV-VIS. RESULTS The elastic modulus G′ of the hydrogel was measured when the ratio of CMCS to SA was 3∶1, 2∶1, 1∶1, 1∶2, and 1∶3. When the ratio of CMCS to SA was 1∶1, G′ was the highest, and the crosslinking strength of the hydrogel was the highest. The cumulative amount of BBH transfer was measured by the BBH transfer model, and the diffusion of BBH in CMCS-SA hydrogel was fitted as the skeleton dissolution by Peppas equation, indicating that BBH dissociation and the transfer efficiency increased as the amino group of CMCS decreased or the carboxyl group of SA increased. The elastic modulus G′ of CMCS-SA hydrogel increased with the increase of GDL content. The reason was that the binding force between CMCS and SA molecules gradually increased with the decrease of pH, and the crosslinking degree of the hydrogel was enhanced. When ratio of fixed CMCS to SA was 1∶1 and the GDL content was 0.15 g·mL−1, the formability of CMCS-SA hydrogel was good. In addition, when BBH was transferred in hydrogel with different concentrations of GDL, the transfer efficiency increased with the increase of GDL content. When BBH was delivered in different thickness hydrogel, the delivery efficiency of CMCS-SA hydrogel increased with the decrease of thickness. CONCLUSION The CMCS-SA hydrogel system, as a potential drug carrier for traditional Chinese medicine extracts such as BBH, is expected to serve as a gel carrier for transdermal drug delivery.

Gel materials have advantages such as comfortable touch, good air permeability, high viscoelasticity, etc., so they are widely used in modern transdermal drug delivery preparations such as patches, gel agents and film agents. With the innovative development of medical materials, many new gel materials with excellent functions have emerged, which has expanded the application scope of transdermal drug delivery preparations and optimized their properties. The classification, properties and application of gel materials in transdermal drug delivery system were reviewed, and the latest research progress was summarized, so as to provide reference for the innovative application of gel materials in transdermal drug delivery system.m.

ObjectiveTo compare the effects of different tidal volumes and positive end expiratory pressures （PEEPs） during mechanical ventilation on the cardiac output of pigs measured by pulmonary artery catheter， transpulmonary thermodilution and pulse contour analysis， and to explore their consistency in cardiac output determination. MethodsTwelve experimental pigs were selected and randomly divided into 3 groups， with 4 pigs in each. Cardiac output was measured by different methods， control group by pulmonary artery catheter， group A by transpulmonary thermodilution and group B by pulse contour analysis. Then we compared the effects of different tidal volumes and PEEPs on the cardiac output of pigs and to explore the consistency. The correlation coefficient between pulse contour analysis and pulmonary artery catheter was r=0.754， and they were positively correlated. The correlation coefficient between transpulmonary thermodilution and pulmonary artery catheter was r=0.771， and they were positively correlated. In determining cardiac output， pulse contour analysis was consistent with pulmonary artery catheter， with a relative error of 13.5% between them； transpulmonary thermodilution was consistent with pulmonary artery catheter， with a relative error of 12.9% between them. The cardiac output decreased significantly along with the increase of tidal volumes or PEEPs and the differences were statistically significant （P<0.05） ConclusionPulmonary artery catheter， transpulmonary thermodilution and pulse contour analysis are well consistent with each other in measuring the cardiac output of pigs. The pigs’cardiac output gradually decreased along with the increase of tidal volumes or PEEPs during mechanical ventilation.

ObjectiveTo determine the genomic characteristics of a subgenus B human adenovirus strain isolated in Shanghai in 2021. MethodsAn adenovirus type 55 strain was isolated and identified from a patient with acute hemorrhagic conjunctivitis （AHC）. Complete genome of the strain was obtained using the next-generation sequencing （NGS）. Phylogenetic trees were reconstructed based on the sequences of Hexon， Fiber， Penton and complete genome to genomically characterize this strain. ResultsPhylogenetic analysis based on the complete genome classified this strain （MH2021001） into subgenus B， subspecies B2 of HAdV-55. Hexon gene of MH2021001 had close phylogenetic relationship with HAdV-11， while Fiber and Penton genes had close relationship with HAdV-14. The MH2021001 showed high nucleotide identity with currently prevalent HAdV⁃55 strains （>99.90%）. The complete genome had 99.96% nucleotide identity to the 73-GD_CHN_2016 strain isolated in Guangdong. In addition， the amino acid sequence of MH2021001 had several substitutions in regions coding for E1B， L4， E3 and L5. ConclusionThis strain has been classified to HAdV-B55. No recombination event is identified in the complete genome. Due to multiple amino acid substitutions， the biological characteristics of the strain need to be further identified.